Tuesday, December 31, 2013

Latest ACA count + Report undermines GOP


White House count of enrollment under Obamacare: -2.1M in private coverage -3.9M in Medicaid -3M under 26 on parents plans
Washington Post | Stunning new report undermines central GOP claim

Daily Beast | Thanks to the GOP, 5 Million Americans Won't Get Health Insurance

Monday, December 30, 2013

The amazing, indisputable slowdown in health spending

1) Ezra Klein (@ezraklein) 30 Dec 13:

Peter Orszag’s graph of the year: The amazing, indisputable slowdown in health spending wapo.st/JFtEpT
Orszag was Obama's first OMB Director and previously Director CBO.

2) Kaiser Family Found (@KaiserFamFound) 30 Dec 13:

If you missed our webinar on #Medicaid & the impact of state decisions – check out the slides & video here ow.ly/s1vyU


Obamacare just might net its 7 million sign-ups


The Media’s One-Sided Coverage of Obamacare

1) HCAN (@HCAN) 29 Dec 13:
The Media’s One-Sided Coverage of Obamacare shar.es/9XXPJ via @ShareThis 


What States Are Doing to Simplify Health Plan Choice in the Insurance 

Monahan, et al, Commonwealth Fund 

3) Commonwealth Fund (@commonwealthfnd)  29 Dec 13: 
The new #healthinsurance marketplaces aim to improve consumers’ purchasing experiences, but how? ow.ly/s5QmC #HIX  

4) Sarah Kliff (@sarahkliff) 29 Dec 13:
Are you guys following @charles_gaba? You should be! He's doing, by far, the best work tracking enrollment at acasignups.net

5) Charles Ornstein (@charlesornstein) 29 Dec 13:

MT @edsilverman: Will Obamacare Give Drugmakers A Boost? CMS Says Yes.. read the forecast data here forbes.com/sites/edsilver… 

Friday, December 27, 2013

Why the ACA is here to stay


Wonkbook: This quote shows why Obamacare is here to stay

Why shouldn’t you just pay the individual mandate?

From KFF


Tuesday, December 24, 2013

Countdown to the end of the first enrollment phase

1) Alert from Maryland Health Connection: Your health coverage is waiting!

Last minute advice for Maryland's exchange.  Kaiser and Evergreen will accept enrollments up to 12/31, Blue Cross and United up to 12/27. This is not well known.  I did receive this email today as I created accounts for testing purposes.  Surprised it did not come sooner.  Maryland still has problems but slowly getting better. 

Seems like enrollment signups has increased dramatically nationwide. 

2) POLITICO.com: HHS offers help for people who miss Obamacare deadline

Health care site put to the test as deadline nears

Obamacare enrollment in private plans tops 600k in 4 states alone.calif, ny, Ky and wash.

3) ACA state exchange premiums

4) Migration Patterns for Medicaid Enrollees 2005–2007

David K. Baugh and Shinu Verghese, Mathematica Policy Research, from a former CMS colleague now with MPR.  

5) Watch out, some #Obamacare plans make you pay thousands out of pocket before full coverage kicks in: khne.ws/19IYRTD

Sunday, December 22, 2013

ACA Public opinion; Premium increases

Kaiser Family Foundation(@KaiserFamFound) 22 Dec 13:

Interactive graph explores trends in public opinion on #ACA over time by race, gender, party ID & more ow.ly/rXA3s #obamacare

Commonwealth Fund (@commonwealthfnd)  22 Dec 13:

Infographic: What drives increases in #healthinsurance premiums? ow.ly/rXNr9  Not ACA. 

Yesterday's Maryland Enrollment fairs +


Emily Koechlin and I spent a couple of hours at the Germantown Center yesterday. Long line of applicants who were in various stages of the application process.  I would guess at least 60 by the time I left at noon. Unfortunately, shortly after we started, it was determined that those who did not have accounts could not be created at the time. Those who did have accounts, the navigators could proceed with.  Most did not have accounts. Most folks were pretty patient, but a couple of them were understandably upset as they have been trying a number of times to work the system.  Several folks could not wait and asked for appointments.  The first 8 requests were provided appointments for Monday morning at the Germantown center,

Mark Ferrenz and several volunteers worked the Silver Spring center and everything worked smoothly there from what he told me.   Wonder why the difference. 

Fortunately, Maryland has extended the enrollment deadline to 12/27 and I understand that they hope to extend until 12/31. 

2) Kaiser Family Found (@KaiserFamFound) tweeted at 10:04am - 21 Dec 13:

ICYMI: Analysis ow.ly/rXyuO estimates number of people eligible for #ACA tax credits in each state #obamacare

Friday, December 20, 2013

Enrollment Surge: Private exchange problems; MD Health Connection Update


2) CNN
Private exchanges: Obamacare shopping still not ready

3) Maryland Health Connection Dec. 20 Update

Some useful info. Deadline extension appears in the works.

3) 27m
The Obama administration estimates 3.9 million people have qualified for Medicaid since October.

RT : Maryland launches Rx Drug Monitoring Program through our Health Information Exchange:

5) Alliance for Health Reform Program on 


If you were unable to attend the briefing, here are some key takeaways:
  • While proposals span different stakeholders and political ideologies, said Paul Ginsburg, they consistently called for the diminished role of fee-for-service models and the increased use of other payment approaches to promote coordination of care and improve patient outcomes.
  • The policy community should help providers already using alternative payment models and those trying or willing to make the transition, Len Nichols stated. He also noted that both government and private payers should give providers incentives to meet global targets.
  • Sheila Burke emphasized that in order to reform payment incentives and programs, proposals recommend linking payment to performance and focusing more on quality.
  • Giving greater authority to states to innovate will improve Medicaid, Ginsburg stated.
I highly recommend Ginsburg's and Nuzum's slides. 

Thursday, December 19, 2013

Where the uninsured live; OFA items; Rising costs

Cool new uninsured map. One census tract in LA has nearly 75% uninsured. Any guesses where?

 2) OFA

a) OFA 2014 Spring Fellows Application Due 1/14.

 b) from the white house: 15 reasons to like ACA

RT : Wow. Single-day enrollment in exchange this week: • Monday: 13,653 • Tuesday: 19,351 • Wednesday: 20,506

Rising medical costs are the reason for recent health insurance premium hikes, not the Affordable Care Act (ACA),


Wednesday, December 18, 2013

Kaiser FF: Year-end ACA update; State + Local News

Listen to a year-end update on the Affordable Care Act Yesterday’s webinar & slides are now online

The slides have excellent material.  

 2)Local News

a) Gazette article about the Capital Region

Navigating the glitches while signing up for healtinsurance 

b) 28m

Obama Enlists 'Moms' to Promote Healthcare Law -my special moment today! via

Neeta is in this video from the White House.  

And this photo

Today, the First Lady joined President Obama to meet with moms who are doing great work to help kids .

 c) Baltimore Sun

Maryland's health exchange site running more smoothly, users say

3  NYT

 Uninsured Americans Are About as Skeptical of Health Care Law as the Insured, Poll Finds


The widespread disapproval, reported in the latest New York Times/CBS News poll, underscores the political challenge facing the Obama administration. 

5) NBC News

Patients pour on to successful state insurance exchanges


Tuesday, December 17, 2013

Maryland deadline now 12/27; + other news

1) Scott MacFarlane (@MacFarlaneNews) 17 Dec 13:

Maryland extends deadline for enrollment for new health insurance program from Dec. 23 to Dec. 27, amid website glitches

2) A lot more of Obamacare has been delayed, cut back, or extended than your probably realize. huff.to/1bXUHYt

3) Fewer than 20% of Blue Shield of CA customers extend health coverage latimes.com/business/money

4) How are consumers protected if their marketplace allows web broker participation? Read our latest brief to find out. bit.ly/JDe6UA

5) Sarah Kliff WaPo  Inevitable. pic.twitter.com/BbjxYEAKFt

6) Sarah Kliff (@sarahkliff) tweeted at 4:42pm - 17 Dec 13:

Why Obamacare won’t spiral into fiery, actuarial doom washingtonpost.com/blogs/wonkblog… 

Next Obamacare crisis: Small-business costs?
​Politico // David Nather
Insurers Fight Hospitals' Paying Premiums
​Wall Street Journal // Louise Radnofsky

A charity's plan to help people pay for coverage through new health-care exchanges has put it at the center of a high-stakes fight between the insurance and hospital industries that could pose a challenge to the economic underpinnings of President Barack Obama's health law.  

Sunday, December 15, 2013

WaPO: O’Malley: Nine ‘major’ problems with online health-insurance exchange have been fixed

In WashPost today: "O’Malley: Nine ‘major’ problems with online health-insurance exchange have been fixed"

How accurate is this article.  I understand at the Silver Spring center yesterday, people left very pleased.  Trying to get more details as to exactly how far they got into the system.  Were they able to enroll in plans. If anyone knows, would appreciate feedback.

O'Malley says major health exchange problems are fixed


The Maryland Health Connection reports that applicants have been able to enroll in plans and paid premiums.  If this is true for most applicants, this is very good news.  Further, the Connection needs to get that word out to all navigators and applicants. 

Saturday, December 14, 2013

1) Criticism of Maryland health exchange; 2) Tackling Costs

Democrats sharpen criticism of Maryland health exchange via Baltimore Sun  

Reports from the Silver Spring Health Center Enrollment Fair is that the navigators are having somewhat more success with the internal network.  Glad to hear. 

2) Went to an Alliance for Health Reform Seminar yesterday

Tackling Health Care Costs: Finding Common Ground 

Some excellent presentations on ways we can improve costs and improve quality.   

Here are the slides for two of the key speakers

Ginsburg Presentation 
Nuzum Presentation 

The event was broadcast on C-Span and I got to ask the first question.  Panel told me afterwards, that they liked the question.   

3)  Benefit Costs: Calm Before the Storm? via

Some interesting results. Do not know how accurate their predictions. 

4)  From the estimable @sam_baker // Take Two Aspirin and Blame Everything on #Obamacare 

5)  From: Healthcare Reform in Action: Montgomery County Leadership Summit that took place on October 28th. The event organizers have prepared this report summarizing the working lunch discussions and outlining the top 10 actionable items that can be addressed in the short term.

Click Here to Download the Report

Friday, December 13, 2013

Morse's site is lead article in CQ HealthBeat

1) Morse's site is Lead Article in CQHealthBeat

See the above link for the full article.  

2) New report has state-by-state economic, mortality impacts of rejection of expansion.

3) The Obama administration wants to make it really, really, really, *really* easy to buy health insurance.

4) Maryland Health Connection 12/13/13 update 

Wednesday, December 11, 2013

Not all drugs or doctors covered.


o   Changing Health Plans, Changing Provider Networks: What They Mean for Consumers and How States Can Help Center on Health Insurance Reforms - Health Policy Institute, Georgetown University by Sabrina Corlette and Sally McCarty 


My comment:
I continue to feel that SteveMorse.org would be very helpful to consumers.  See my article published by Hearst Newspapers: CONSUMER SHOPPING SITES HELP YOU ENROLL IN OBAMACARE http://tinyurl.com/hraconsumershopping   I have a number of other suggestions for the Maryland Health Connection.


Health care prices in October rose 0.9% from Oct.'12 - smallest increase in more than 50 years.  

This is consistent with recent data.  The cost curve has been significantly declining over the last few years, and even more so since ACA.   Not certain if ACA is a factor but quite possible it is.  There are many features in ACA not so well known that can contribute to the decline.  

Share of privately insured women paying $0 out of pocket for oral contraceptives grew from 15 to 40%  

Thanks to the ACA, preventive care from birth control to checkups to cancer screenings is covered for free, without a copay, under every insurance plan.  

Impressive stats.  


A Guide to the Supreme Court's Review of the Affordable Care Act's Contraception Coverage Requirement

A new policy brief

9) November federal marketplace stats, plus all the latest state numbers, sortable and with pictures:  

Tuesday, December 10, 2013


Please spread the word. Welcome advice and assistance in getting the attention of policymakers at State and Federal levels. 

(For use by New York Times News Service clients.)@<
c.2012 Hearst Newspapers@
We all know about the considerable problems of Healthcare.gov, the federal health insurance exchange serving the Affordable Care Act — Obamacare. Because 36 states have refused to create their own exchanges, Healthcare.gov is the main portal for millions of uninsured (or underinsured) seeking to shop online for affordable health coverage.
After the botched rollout in October, the White House brought in scores of tech experts to make it work as intended. To a large extent, they succeeded although many users still find they must wait until the system is less inundated in order to enroll.
But no matter where or how consumers sign up, it is essential they make careful decisions as to which plans are the best for them and their families. If you're shopping for a plan, it's best to review the available choices according to premium prices, government subsidies, quality ratings and doctor participation.
In the past few months, a number of Web sites have been developed by those outside government that permit consumers to do side-by-side comparisons before logging on to the federal or state exchanges. The most well-known sites include Kaiser Family Foundation, Valuepenguin, and Sherpa.
Another such site has been set up by Steve Morse, a San Francisco computer professional with a doctorate in electrical engineering.
He has lived a dual life. In his early years his claim to fame was that he was the architect of Intel's 8086 processor which was the predecessor to the Pentium processor that is used in most PCs today. More recently he has been applying his computer skills to genealogy and developed easy-to-use interfaces to many otherwise cumbersome genealogy websites. For this he has received numerous awards, including a prestigious Lifetime Achievement award from a major genealogical society.
Morse has no interest in providing information on healthcare per se. But when he kept hearing about all the problems with viewing plans on healthcare.gov, he realized that this was no different than the genealogy websites for which he had been developing better interfaces. To make the point, he decided to spend a day to come up with a better interface for viewing the healthcare plans.
On Morse's site, stevemorse.org/obamacare/obamacare.html, you can search for health plans offered in your state. All the sites provide information on premiums and government subsidies. And several of them present the results in table form so that consumers can compare the different plans side by side. By contrast, the federal and most state exchanges give you one plan at a time to look at.
Morse's site does what the other non-governmental sites do and additionally gives you quality ratings from Consumer Reports and information on doctor participation. For many consumers, it is important to know which doctors participate in a plan especially if they want to keep the doctors they have been using.
So, notwithstanding the Website problems past and present, the good news for consumers is there are options that help you make informed decisions for you and your family before you ever sign on to Healthcare.gov or your state exchange.
What these sites do not do is actually enroll you in a health insurance plan. Only the Federal- or state-based sites do that. Soon the insurance companies themselves may also serve that function.
Zeke Emanuel, an architect of the Affordable Care Act and brother of Chicago mayor and former White House chief-of-staff Rahm Emanuel, may have said it best in POLITICO: "When individuals and families can go online, browse through their coverage options and see the new benefits for which they are eligible, they will be more likely to give Obamacare a chance — even if the back end of the website doesn't let them enroll immediately."
Don't let the Obamacare doomsayers out to score political points make up your mind for you. If you and your family have been without insurance or have inadequate insurance, the tools are out there to help you get an affordable plan that gives you solid coverage.
Tony Hausner retired as a Senior Analyst for the U.S. Centers for Medicare and Medicaid Services (CMS), which is overseeing implementation of the Affordable Care Act.